What Is Stage 4 Nasopharyngeal Carcinoma?

Reviewed on 3/17/2022

Illustration of nasopharyngeal carcinoma
Stage 4 nasopharyngeal carcinoma is an advanced stage of the cancer in which the tumor has spread beyond the nasopharynx. Stage 4 nasopharyngeal carcinoma is subdivided into stages 4A, 4B, and 4C.

Nasopharyngeal carcinoma is a type of head and neck cancer that occurs when cells in the nasopharynx, the upper part of the throat behind the nose and near the base of the skull, grow out of control.

Stage 4 nasopharyngeal carcinoma is an advanced stage of the cancer in which the tumor has spread beyond the nasopharynx. Stage 4 nasopharyngeal carcinoma is subdivided into stages 4A, 4B, and 4C. 

  • Stage 4A nasopharyngeal carcinoma
    • Has spread beyond the nasopharynx 
    • May have spread to the skull and/or cranial nerves, the main salivary gland, or the eye or its nearby tissues 
    • May also have spread to one or more lymph nodes in the neck and/or to lymph nodes behind the pharynx
      • Affected lymph nodes are six centimeters or smaller
    • Has not spread to distant parts of the body (M0).
  • Stage 4B nasopharyngeal carcinoma 
    • Has spread to lymph nodes between the collarbone and the top of the shoulder and/or the affected lymph nodes are larger than six centimeters
  • Stage 4C nasopharyngeal carcinoma 
    • Has spread beyond nearby lymph nodes to other parts of the body

What Are Symptoms of Nasopharyngeal Carcinoma?

Symptoms of nasopharyngeal carcinoma include: 

  • A lump or mass in the neck 
  • Headaches
  • Nasal blockage or stuffiness
  • Facial pain or numbness
  • Nosebleeds
  • Ringing in the ear (tinnitus)
  • Feeling of fullness in the ear (especially on one side only)
  • Ear pain
  • Recurrent ear infections (more common in children)
  • Hearing loss
  • Trouble opening the mouth
  • Blurred or double vision
  • Difficulty breathing or talking

What Causes Nasopharyngeal Carcinoma?

The cause of most cases of nasopharyngeal carcinoma is unknown. 

Risk factors for developing nasopharyngeal carcinoma include: 

  • Being male 
  • Where you live or ethnicity
    • Most common in southern China (including Hong Kong), Vietnam, Singapore, Malaysia, the Philippines, Northwest Canada, and Greenland
    • In the U.S., it is most common in Asian and Pacific Islanders (particularly Chinese Americans), Native American and Alaskan natives, African Americans, whites, and Hispanics/Latinos
  • Diet
    • Diets very high in salt-cured fish and meat 
    • This diet is common in areas where the cancer is more prevalent
  • Smoking
  • Heavy alcohol use
  • Family history
  • Infection with Epstein-Barr virus
  • Workplace exposure to formaldehyde (possible; link is not clear)

How Is Nasopharyngeal Carcinoma Diagnosed?

In addition to a medical examination and patient history, tests used to diagnose nasopharyngeal carcinoma include:

  • Biopsy
  • Imaging tests
  • Blood tests
    • Complete blood counts (CBC
    • Blood chemistry 
    • Epstein-Barr virus (EBV) DNA levels

What Is the Treatment for Nasopharyngeal Carcinoma?

Treatment for nasopharyngeal carcinoma includes:

  • Surgery 
    • Surgical removal of the tumor
    • Surgical removal of lymph nodes
  • Radiation therapy 
  • Chemotherapy
  • Targeted therapy 
  • Immunotherapy 

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Reviewed on 3/17/2022
References
Image Source: iStock Images

https://www.cancer.org/cancer/nasopharyngeal-cancer.html

https://stanfordhealthcare.org/medical-conditions/cancer/nasopharyngeal-cancer/nasopharyngeal-cancer-staging.html